Colman Nancy, Bakker Annemieke, Linzer Mark, Reitsma Johannes B, Wieling Wouter, Wilde Arthur A M
Department of Cardiology B2, Academic Medical Centre, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
Europace. 2009 Jul;11(7):937-43. doi: 10.1093/europace/eup101. Epub 2009 May 29.
Long QT syndrome (LQTS), a potentially fatal disorder, has to be distinguished from non-fatal conditions. Our aim was to investigate whether history-taking can be used in identifying patients likely to have LQTS.
We compared the characteristics of a group of LQTS patients with syncope patients presenting at the emergency department (ED) and vasovagal patients younger than 40 years of age. Thirty-two LQTS patients were included. We included 113 patients at the ED and 69 vasovagal patients. Family history of syncope, sudden cardiac death, or cardiovascular disease was found more often in LQTS patients. Palpitations were the only symptom reported more often in this group. Syncope while supine, during emotional stress and associated with exercise was also more common among LQTS. Standing as a trigger was found more often in ED and vasovagal patients.
We conclude that a family history for syncope and sudden cardiac death, palpitations as a symptom, supine syncope, syncope associated with exercise, and emotional stress place patients at higher risk for LQTS. These findings should alert physicians to the potentially life-threatening illness of LQTS, and act accordingly by obtaining an electrocardiogram and paying specific attention to the QT interval.
长QT综合征（LQTS）是一种潜在的致命性疾病，必须与非致命性疾病相区分。我们的目的是研究病史采集是否可用于识别可能患有LQTS的患者。
我们比较了一组LQTS患者与急诊科就诊的晕厥患者以及40岁以下血管迷走性晕厥患者的特征。纳入了32例LQTS患者。我们纳入了113例急诊科患者和69例血管迷走性晕厥患者。LQTS患者中晕厥、心源性猝死或心血管疾病的家族史更为常见。心悸是该组中唯一报告较多的症状。仰卧位、情绪应激时以及与运动相关的晕厥在LQTS患者中也更为常见。在急诊科患者和血管迷走性晕厥患者中，站立作为诱发因素更为常见。
我们得出结论，晕厥和心源性猝死的家族史、心悸症状、仰卧位晕厥、与运动和情绪应激相关的晕厥使患者患LQTS的风险更高。这些发现应提醒医生注意LQTS这种潜在的危及生命的疾病，并通过进行心电图检查并特别关注QT间期来采取相应行动。
